Brief notes on main Clinical Indications of Fluid Replenishment

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1. For the correction or prevention of Shock or Circulatory failure due to substantial haemorrhage or blood loss or exudation of plasma as in extensive burns.

The ideal replenishment fluid in the former case is blood, in the latter blood or plasma.

2. For the correction or prevention of dehydration in conditions like severe dirrhoea and/or vomiting and excessive sweating resulting from heat exhaustion. The ideal replenishment fluid is a fluid composed of the appropriate Electrolytes (salts) and Glucose in suitable strengths.

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oral rehydration therapy (ort) has come into vogue as it can be easily administered in domestic conditions and can often prevent the need of intravenous fluid therapy if timely undertaken. Glucose-Electrolyte mixture of various brands in powder form (meant to be reconstituted with cooled boiled water) is now getting popular. W.H.O. recommended formula is composed of Sodium chloride—3.5 gms. Sodium bicarbonate—2.5 gms, Potassium chloride—1.5 gms. Glucose—20 gms. Presently, use of Trisodium citrate’ 2.9 gm in place of ‘Sodium bicarbonate’ is preferred. It will be converted into alkali in the system. This powder is to be dissolved in 1 liter of water. This oral rehydration solution (ORS) when reconstituted in one liter of water has the relevant Electorlyte composition as follows : Sodium (90 mEq/1), Potassium (20 mEq/1), Chloride (80 mEq/1), Bicarbonate (30 mEq/1).

[In the cause of infants and young children, the Glucose— Electrolyte powder of the above formula should be reconstituted with one and half liters of water (instead of one liter) in order to prevent the possibility of ‘Hypernatraemia’.]

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